Presentation
Malaria may have been a contributory factor rather than the sole cause in our patient who presented with a stroke. [doi.org]
CONCLUSIONS: The present study found higher genetic polymorphism in the PkRAP-1 gene than the polymorphism level reported in a previous study. [ncbi.nlm.nih.gov]
Entire Body System
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Splenectomy
Splenectomy was performed. Histopathological examination findings were suggestive of splenic rupture and presence of malarial pigment. Analysis of his blood sample by nested PCR assays confirmed P. knowlesi infection. [ncbi.nlm.nih.gov]
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Chest Discomfort
We report a case of severe Plasmodium knowlesi and dengue coinfection in a previously healthy 59-year-old Malay man who presented with worsening shortness of breath, high-grade fever with chills and rigors, dry cough, myalgia, arthralgia, chest discomfort [ncbi.nlm.nih.gov]
Respiratoric
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Productive Cough
Fever and chills were present in almost all cases, and other frequent symptoms included abdominal pain, breathlessness, and productive cough. Tachypnea, pyrexia, and tachycardia were common clinical signs ( table 1 ). [doi.org]
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Dry Cough
We report a case of severe Plasmodium knowlesi and dengue coinfection in a previously healthy 59-year-old Malay man who presented with worsening shortness of breath, high-grade fever with chills and rigors, dry cough, myalgia, arthralgia, chest discomfort [ncbi.nlm.nih.gov]
Gastrointestinal
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Abdominal Tenderness
He had generalized abdominal tenderness, maximal at the epigastric region. Bedside focused abdominal ultrasonography revealed free fluid in the abdomen. [ncbi.nlm.nih.gov]
On examination, he was jaundiced and hypotensive, and he had generalized abdominal tenderness and a palpable spleen. Malaria was suspected, and a blood film was reported to show 112,000 P. malariae parasites/µL. [doi.org]
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Epigastric Tenderness
She began receiving intravenous rehydration and oral metronidazole, but she became hypotensive overnight and was transferred to the district hospital on day 2, where the main finding of physical examination was epigastric tenderness. [doi.org]
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Severe Abdominal Pain
All 4 PCR-confirmed fatal cases of P. knowlesi were hyperparasitemic, and all 4 patients presented with severe abdominal pain and a history of fever and chills. [doi.org]
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Epigastric Pain
A 66-year-old woman presented to her local health post on day 1 with a 3-day history of epigastric pain, diarrhea, vomiting, fever, and rigors. Malaria was not considered to be a possible diagnosis. [doi.org]
Liver, Gall & Pancreas
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Hepatosplenomegaly
Hepatosplenomegaly was the only clinical finding; laboratory tests showed thrombocytopaenia, lymphopaenia, mild anaemia and liver transaminitis. [ncbi.nlm.nih.gov]
Eyes
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Retinal Pigmentation
Nonspecific retinal whitening occurred in 3 (35%) and 5 (29%) patients with severe and nonsevere disease, respectively; hemorrhages in 2 (17%) and 3 (18%); loss of retinal pigment epithelium in 1 (8%) and 4 (24%); and drusen in 9 (71%) and 12 (75%). [ncbi.nlm.nih.gov]
Musculoskeletal
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Arthralgia
In September 2012, a previously healthy 35-year-old Japanese man presented to National Center for Global Health and Medicine in Tokyo with a two-day history of daily fever, mild headaches and mild arthralgia. [ncbi.nlm.nih.gov]
Psychiatrical
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Distractibility
Treating the dengue had so distracted the clinicians that a blood film for the malaria parasite was not done. [ncbi.nlm.nih.gov]
Neurologic
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Dizziness
Symptomatic patients presented mild to moderate symptoms like fever, chills, headache, dizziness, fatigue and myalgia.Although both the intermediate as well as the definite host are known to be endemic in southeastern Bangladesh, no evidence for the presence [ncbi.nlm.nih.gov]
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Stroke
Malaria may have been a contributory factor rather than the sole cause in our patient who presented with a stroke. [doi.org]
Workup
Microbiology
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Rickettsia Typhi
Results of dengue reverse transcription–PCR (RT-PCR) on serum, 2 sets of blood cultures, and Rickettsia typhi serologic testing were negative. Results of a chest radiograph and ultrasound of the abdomen were normal. [doi.org]
Biopsy
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Liver Biopsy
The former becomes mature between the 8th and 9th day after the blood meal, at 26 C. and in a relative humidity of 80 per cent. 6. (6) The pre-erythrocytic schizogony of P. knowlesi is described from forms seen in liver biopsies made, and days after the [doi.org]
Treatment
No randomised controlled trials have been done to identify the optimum treatment for this emerging infection. [ncbi.nlm.nih.gov]
Late treatment failure was seen in one patient with vivax malaria with the presence of a rising parasitaemia on day 4 of treatment. [doi.org]
Prognosis
Although late stages of parasites may be visible in the blood in falciparum infections, they are rare and associated with a poor prognosis. [doi.org]
Blood examination and prognosis in acute falciparum malaria. Trans. R. Soc. Trop. Med. Hyg. 43 :33–48 [ PubMed ] [ Google Scholar ] 99. World Health Organization 2011. [ncbi.nlm.nih.gov]
Etiology
Because P. malariae infection was not consistent with the clinical findings of the initial examination, we investigated further to determine the etiology of this case. [doi.org]
Epidemiology
Epidemiological data on malaria for Sarawak has been derived solely from hospitalized patients, and more accurate epidemiological data on malaria is necessary. [ncbi.nlm.nih.gov]
Plasmodium knowlesi/isolation & purification, Thailand/epidemiology, Travel", author "Antoine Berry and Xavier Iriart and Nathalie Wilhelm and Alexis Valentin and Sophie Cassaing and Benoit Witkowski and Fran{\cc}oise Benoit-Vical and Sandie Menard [pure.au.dk]
Pathophysiology
KEYWORDS: Plasmodium knowlesi; in vivo; non-human primate; pathophysiology; severe malaria [ncbi.nlm.nih.gov]
The severe form of P. knowlesi malaria can be compared with severe falciparum malaria to inform the pathophysiology of both infections. P. knowlesi presents new challenges to malaria -control efforts in Southeast Asia. [journals.lww.com]
Part of the difficulty in studying the pathophysiology of P. falciparum malaria is the lack of a permissive animal model and a comparator disease in man. [doi.org]
Therefore, one of the most exciting opportunities in the study of P. knowlesi pathophysiology in humans is the ability to test correlates of pathophysiology in representative animal models. [asmscience.org]
Prevention
CONCLUSIONS: Taken together with reports of clinical failures when P. knowlesi is treated with mefloquine, the data suggest that caution is required if using mefloquine in prevention or treatment of P. knowlesi infections, until further studies are undertaken [ncbi.nlm.nih.gov]
Intermittent preventive treatment for the prevention of malaria during pregnancy in high transmission areas. Malar J. 2007 Dec 4. 6:160. [Medline]. [Full Text]. Trape JF, Tall A, Diagne N, et al. [medscape.com]
Additional management strategies are therefore needed to prevent and reduce severity of AKI in malaria. [hotnorth.org.au]